脑内脱髓鞘假瘤

Demyelinating pseudotumor of the brain: report of 11 cases

目的探讨脑内脱髓鞘假瘤的病理特点。方法回顾性分析11例经手术证实的脑内脱髓鞘假瘤的临床与影像学表现、病理特点、治疗效果及随访情况。结果脱髓鞘假瘤以急性起病为主,病程呈单时相;影像学多表现为皮质下单一病灶、其强化呈非闭合性或与脑室垂直;病理学发现病灶呈炎性脱髓鞘样改变。结论脱髓鞘假瘤临床表现各异,典型的临床及影像学表现有助于诊断;组织病理学检查是确诊的金标准。脱髓鞘假瘤不宜手术治疗,肾上腺皮质激素对此病治疗效果好。

Objective To analyze the pathological changes of demyelinating pseudotumor lesion of the brain. Methods Eleven cases which were confirmed as demyelinating pseudotumor of the brain in pathology after the operation were retrospectively analyzed, including all the clinical features, image data, pathological changes, therapeutic effects and follow-up data. Results The acute onset of demyelinating pseudotumors appeared to be more predominant. The course of diseases was gradually progressive with the increased or aggravated symptoms. In most cases, the neuroimaging showed a single subcortex focal lesion which could be enhanced. The enhanced pattern was open ring-like or vertical to the cerebral ventricle. Pathological examination indicated the typical inflammatory demyelination. Conclusion Demyelinating pseudotumor is of a variety of clinical manifestations. Typical clinical and neuroimaging features are beneficial to the diagnosis of the disease, and histopathological examination is a gold standard for definite diagnosis. Drug therapy should be preferred in the treatment of demyelinating pseudotumor, with corticoid being more effective.